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Hallux Valgus

                                                                                                                         Mr Tim Clough

Consultant Orthopaedic Surgeon

Common name

  • Bunion

Who does it affect?

Bunions tend to run in families, but that does not mean that if you have a bunion your children will have one too. More common in females and more common in the over fifties. 

Symptoms

Pain over the bony prominence, usually from pressure of the shoe. Sometimes the skin over the lump becomes red and infected. Often the big toe can rub on the second toe, pushing it up and out of joint, causing pain under the ball of the foot. 

Investigations

X-ray of the foot is required to illustrate the magnitude of the deformity and any associated arthritis.

Non-operative treatment

Painkillers (analgesia) and accommodative shoewear (wide fitting, deep toebox, soft leather uppers). Occasionally insoles can help.

Operative treatment

If the above non-surgical measures are unhelpful, surgery is performed under general anaesthesia or regional anaesthesia (only the foot is numb). A tourniquet is used, which is like a blood pressure cuff around the upper thigh which prevents blood from obscuring the surgeonís view. There are a few different operations for bunions depending upon the severity of the deformity and whether any associated arthritis has developed in the big toe joint. Most involve cutting and realigning the bones in the forefoot to narrow the forefoot, excise the bony prominence and straighten the big toe. If additional surgery is required to the second toe then often a K wire is used temporarily (for a period of four weeks) to hold the position whilst the wounds heal. Skin is sutured and a plaster slab is sometimes used depending on surgeon preference. Patients would be allowed to fully weight bear post-operatively.